Name: psychophysically-anchored, robust thresholding in studying pain-related lateralization of oscillatory prestimulus activity
Uploaded: 2017-01-21T14:00:00.000+00:00
Duration: 7 min 28 s
Description: Watch this Scientific Journal Video about Psychophysically-anchored, Robust Thresholding in Studying Pain-related Lateralization of Oscillatory Prestimulus Activity at JoVE.com

This work has been funded by the Transregional Collaborative Research Centre TRR169 &#34;Crossmodal Learning: Adaptivity, Prediction and Interaction&#34; / German Research Foundation (DFG). The authors thank Stephanie Shields for the helpful comments on the manuscript.

The experiment has been approved by the ethics commission of the Hamburg medical association (PV4509).
1. Participant Selection
<ol>
	<li>Beyond standard selection criteria, such as fitness for pain stimulation, head implants or pre-existing neurological conditions, make sure the participants are not suffering from acute or chronic pain, are not taking any pain medication, and have no known history of substance abuse. Participants should also not have taken part in any pharmacological studies during the 4 weeks prior to the experiment.</li>
	<li>Include participants of any gender, yet take care to only include female participants that are using hormonal contraceptives13,14 to minimize the effect of cyclic changes in pain perception.</li>
	<li>Before administering any kind of stimulation, make sure participants have given informed consent in writing.</li>
</ol>
2. EEG Setup
<ol>
	<li>Select an appropriate cap size and prepare the EEG electrode setup as per the system&#39;s instruction manual.</li>
	<li>Set the sample rate and high/low cutoff as well as the impedance limits of the recording equipment (recommended: 500 Hz, 0.5 Hz high-pass filter, impedances &#60;20 k&#8486;).</li>
	<li>Make sure the stimulation device and the EEG device are not electrically coupled by running the EEG system on battery.</li>
	<li>Ensure that any link between the EEG system and the computer controlling the electrical stimulation device is potential-free.</li>
</ol>
3. Electrical Stimulation Setup
<ol>
	<li>To best make use of the time resolution of the EEG recording, keep the electrical stimulation as short as possible. Set the stimulator to a single, monophasic stimulation pulse with 1 ms duration and 400 V maximum voltage. If a more intense pain level is needed, or the exact timing of the post-stimulus EEG recording does not take precedence, other stimulation protocols can be used.</li>
	<li>Make sure the electrical stimulator is switched on but the output to the electrode is switched off. For the DS7A stimulator the switch labeled &#39;OUTPUT&#39;&#160;to the right of the device should be in the down position.</li>
	<li>Locate the landmark(s) that identify the chosen stimulation site. For a stimulation at the hand, use the muscle between thumb and index finger (abductor/flexor pollicis brevis). Ask the participant to lay their hand on a flat surface with all digits stretched out and apposed. Identify the stimulation site by bisecting the distance between the first knuckles of the thumb and index finger.</li>
	<li>Clean the skin by applying electrode preparation gel. Make sure not to use alcohol or disinfectant, which might leave residue on the skin that can lead to irritation or unreliable stimulation.</li>
	<li>Attach the stimulation electrode and fasten it in place with textile tape.</li>
	<li>Ask the participant to find a comfortable position for the hand and to try not to move the hand during the experiment, if possible. For the participant&#39;s convenience, place a soft tissue under the hand to absorb any humidity, depending on the surface permeability.</li>
	<li>Enable the stimulator&#39;s output by switching the &#39;OUTPUT&#39;&#160;switch to the upward position.</li>
</ol>
4. Determine Starting Points
<ol>
	<li>Instruct the participant on how to operate the rating scale on the screen using the mouse. The left half represents non-painful sensations; the right half corresponds to a standard pain VAS scale, providing a visual equivalent for a range of continuous sensation intensities in the form of a horizontal line. Point out to the participant that the absolute center point of the scale cannot be selected. Provide the participant with the standardized instructions about the anchor points15 (Table 1).</li>
	<li>Give the participant the opportunity to get comfortable with the rating process by applying stimuli of varying intensity and recording the responses. Use the information gathered during this phase to get an estimate for two intensities that consistently evoke strong but nonpainful sensations (low-point) and moderately painful sensations (high-point), respectively. Continue the stimulation for about 25 - 30 trials or until satisfied with having reached good estimates. During this time, it can be beneficial to query the participant for verbal feedback on the intensities and the subjective similarity of repeatedly presented stimulus intensities.</li>
	<li>Try to pick the intensities randomly to evoke responses around the scale center. For best results, do not simply increase or decrease the intensities linearly, and also explore the more extreme ends of the painful side. This phase should also give the participant the opportunity to get accustomed to the potentially unfamiliar stimulation and establish some reference for a consistent rating range. Because of this, it is advisable to apply intensities from the whole range of possible stimulus intensities, while also repeating some intensities.</li>
	<li>Once satisfied with having obtained estimates for both a high-point and low-point starting intensity, inform the participant that the first part of the experiment is about to start and (s)he should keep on rating as practiced while random stimulus intensities are presented.</li>
</ol>
5. Determine Threshold
NOTE: The QUEST algorithm requires some parameters to be specified before starting estimation. Those parameters include the steepness of the psychophysical function (beta, typically 3.5), the fraction of trials where a random answer is expected (delta, typically 0.01), and the fraction of trials where a positive response is expected even though no stimulation is given (gamma, no recommendation). For Bayesian estimation, the range (SD) of the expected ratings and the spacing of possible responses (grain) must be specified. For a VAS, grain should be set to the resolution of the scale (typically 1), and the SD should be set large enough to include both the scale zero point and the maximum possible intensity plus some safety margin. The recommendations and &#34;typical&#34; values given here are explained in detail in the QuestCreate source code included with PsychToolbox6,16. For pain at the threshold, a gamma value of at most 0.01 should be plausible. The estimation method is relatively robust in terms of misspecification of the parameters, however for settings with only few trials, failure to specify sensible parameters might increase the uncertainty of the final estimate. If the standard deviation is set too low, the procedure will have problems converging on estimates that lie outside the area spanned by the standard deviation around the prior guess for the parameter. Thus it is important to rather err on the side of a too large standard deviation.
<ol>
	<li>Create two QUEST sessions with the parameters given above. Start one from the high-point intensity and one from the low-point. Information about the implementation logic of the estimation process can be found in the supplemental material (S1).</li>
	<li>Randomly select a probe intensity of one of the two runs given by the respective QuestMean function.</li>
	<li>Set the electrical stimulator to the probe intensity. If a different intensity than the one suggested by the algorithm needs to be applied or the suggested intensity is out of range, feed the presented intensity back into the QuestUpdate function in step 5.5.</li>
	<li>Trigger the stimulus.</li>
	<li>After the participant has rated the stimulus, run QuestUpdate for the respective estimation session and supply it with the actual stimulus intensity presented as well as the participant&#39;s rating.</li>
	<li>Continue running rating trials until the estimates are stable or a predefined stopping criterion (&#62;40 trials) has been reached.</li>
	<li>Record the mean threshold estimate between both estimation runs, starting from the high and low starting point as given by QuestMean.</li>
	<li>Allow the participant to take a break at this stage, if desired.</li>
</ol>
6. Stimulate at Threshold Level
Note: It is possible to adjust the rating and block count to your needs as long as it is tolerable to the participant.
<ol>
	<li>Inform the participant that for the remaining part of the experiment, more blocks with random stimulation will be following and they should keep rating as they did before. If needed, refresh the instruction on the scale anchor points.</li>
	<li>Start the EEG recording.</li>
	<li>Set the electrical stimulator to the mean threshold estimate obtained in step 5.7 and keep the setting constant throughout the rest of the experiment.</li>
	<li>Start a rating block (30 trials) and observe the data quality of the EEG recording. Depending on the EEG data quality, run 4 - 5 rating blocks and allow the participant to take short breaks in between the blocks. 
	NOTE: Try to keep social interaction with the participant to a minimum during these breaks or standardize the interaction as much as possible.</li>
	<li>When finished, stop the EEG recording, switch the stimulator output to off, and remove the electrode. Debrief the participant after removing the EEG cap.</li>
</ol>

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The authors declare that they have no competing financial interests.

Here we used the well theoretically founded QUEST method to efficiently estimate a robust psychophysical threshold between non-pain and pain perception. Using constant stimulation at this threshold enables an analysis of perceptual decisions independent of changes in stimulus magnitude. While we examined threshold intensity at the transition point between innocuous and noxious sensation domains, other points along the pain scale (e.g.,&#160;50 on a 100-point pain scale) can also be anchored with the here present...

When conducting behavioral experiments involving human participants, it is important to be able to closely control the intensities of presented stimuli. Using stimuli of equal intensity for all participants, however, will in some settings introduce the bias of subjective perception. For some perceptual qualities such as pain, there are high inter- and intra-individual variations in perceived intensity at a constant stimulus level1,2. For experiments that assume equal subjective percepts, it is thus a necessity to match the subjectively perceived intensity across participants. This is also important when examining perception at threshold level, e.g., between painful and nonpainful stimulation. Psychophysics research has addressed these kind of problems for decades, and today there are sophisticated but easy-to-use methods available to achieve robust psychophysical anchoring.
A simple, classical method of mapping the intensity of a stimulus to an individual sensation magnitude is the staircase method3. Hereby, the intensity of successive stimuli is increased or decreased, until there is a change in the participant&#39;s response relating to the desired threshold or position on the subjective sensation scale. Repeating this process&#160;number of times, yields a plausible estimate of the reversal point. Classical methods, however, fail to make use of all the information contained in each rating trial. This leads to an unnecessarily high number of trials required to reach convergence. Methods such as (linear) regression or function fitting might fail, if the assumptions for the relationship between stimulus intensity and sensation magnitude are wrong or do not hold for the tested stimulus range. The adaptive procedures not only yield a robust point estimate for a certain subjective intensity, but do so more efficiently. Especially for longer experiments, which heavily rely on accurate estimation of a threshold or sensation magnitude, it is necessary for the psychophysical method to be both robust and at the same time efficient with respect to the number of required trials. This is especially important in fields such as pain research, where the total exposure to painful stimulation should be kept as low as possible for the participants&#39; benefit.
Although the classical staircase methods are still widely used, e.g. in quantitative sensory testing, the use of more advanced estimation methods that make better use of the acquired information across trials is steadily increasing. In the case of the maximum likelihood estimation method QUEST4,5 used here, this is probably due to the readily available implementation in the popular Matlab PsychToolbox6 suite. The modern, revised version of this procedure is superior to classical estimation methods both in robustness and the low number of trials required to arrive at a sufficient estimate, if used with the right settings7.
The rationale behind the QUEST procedure is to fit a Weibull function to the incoming data to model the psychophysical transformation between stimulus intensity and sensation magnitude. The parameters for the psychophysical Weibull function are in part given by the experimenter, e.g. the steepness of the function or the offset due to the false positive rate and responder inconsistency. The positioning of the parameter of interest along the intensity dimension is approximated by the procedure using Bayesian maximum likelihood estimation. Hereby, a probability distribution is assumed over the location of the target parameter, i.e. the threshold intensity. Given a sensible prior assumption for such a distribution, the algorithm will determine the most informative intensity that the participant should respond to. For the current implementation of the procedure, this is the mean of the prior probability distribution8. For each successive trial, the prior probability distribution is in essence multiplied with the likelihood of the participant&#39;s given response at the tested stimulation level, as characterized by the Weibull function. Every response will be used to continuously update the probability distribution estimate for the threshold parameter. This procedure is repeated until a satisfying estimate is produced. The procedure is more efficient than a simple regression because it makes immediate use of the collected responses to determine which stimulation intensity to test next. Also, the procedure will specifically probe around the point of interest, e.g. a threshold or certain sensation intensity. Using only testing data from such a limited range in regression would lead to an unstable estimate, making adaptive procedures more robust in settings where only relatively low numbers of trials are feasible.
Such robust psychophysical anchoring can be used to measure changes in pain sensitivity over time, modulatory effects in hyperalgesia/allodynia research or analgesic effects in pharmacological interventions, amongst other settings. Another interesting prospect of being able to anchor stimuli to the intensity just at the threshold between two sensory continua is to examine subjective perception across the transition from non-painful to painful sensation9,10,11. This scenario is very interesting because if the pain threshold has been robustly estimated, pain and no-pain conditions can be contrasted in electroencephalographic (EEG) activity, for example, without changing the physical stimulus intensity12. This allows for the observation of pain-specific perceptual processes under constant stimulus conditions by examining the difference in brain activity between trials rated as painful and non-painful.
We will demonstrate how to use the readily available implementation of adaptive estimation in PsychToolbox to robustly determine the individual pain threshold in an EEG experiment where the contrast between pain and no-pain activity is examined for lateralization effects, depending on the stimulation site. Since the stimulation intensity can be kept constant after the thresholding procedure, it is not necessary to account for EEG activity co-varying with stimulus intensity in the subsequent analysis.

<table><tbody><tr><td>EasyCap electrode cap</td><td>EasyCap, Woerthsee-Etterschlag, Germany</td><td>CUCHW-58</td><td></td></tr><tr><td>actiCap active Ag/Cl EEG electrode set</td><td>BrainProducts GmbH, Gliching, Germany</td><td>-</td><td></td></tr><tr><td>SuperVisc EEG eletrode gel</td><td>EasyCap, Woerthsee-Etterschlag, Germany</td><td>V16</td><td></td></tr><tr><td>BrainAmp EEG amplifier</td><td>BrainProducts GmbH, Gliching, Germany</td><td>BrainAmp Standard</td><td></td></tr><tr><td>PsychToolbox-3</td><td>Mario Kleiner / Open Source</td><td>-</td><td>Available at http://psychtoolbox.org/</td></tr><tr><td>Matlab</td><td>MathWorks, Natick, MA</td><td>Matlab R2015b</td><td></td></tr><tr><td>DigiTimer DS7A constant current electrical stimulator</td><td>DigiTimer Ltd., Hertfordshire, United Kingdom</td><td>DS7A</td><td></td></tr></tbody></table>

psychophysically-anchored, robust thresholding in studying pain-related lateralization of oscillatory prestimulus activity

In perceptual studies, it is often important to objectively assess the equality of delivered stimulation across participants or to quantify the intra-individual sensation magnitude that is evoked by stimulation over multiple trials. This requires a robust mapping of stimulus magnitude to perceived intensity and is commonly achieved by psychophysical estimation methods such as the staircase procedure. Newer, more efficient procedures like the QUEST algorithm fit a psychophysical function to the data in real time while at the same time maximizing the efficiency of data collection. A robust estimate of the threshold intensity between painful and nonpainful perceptions can then be used to reduce the influence of variations in sensory input in subsequent analyses of oscillatory brain activity. By stimulating at a constant threshold intensity determined by an adaptive estimation procedure, the variance in the ratings can be directly attributed to perceptual processes. Oscillatory activity can then be contrasted between &#34;pain&#34; and &#34;no-pain&#34; trials directly, yielding activity that closely relates to perceptual classification processes in nociception.

Using a rating scale split into one half for nonpainful and one half for painful sensations (Figure 1a), constant stimulation can be applied over many trials while still yielding ratings across the scale midpoint (Figure 1b). This way, changes in sensory input can be avoided, and the rating outcome can be directly related to intrinsic perceptual classification processes related to pain.
<img alt...

Watch this Scientific Journal Video about Psychophysically-anchored, Robust Thresholding in Studying Pain-related Lateralization of Oscillatory Prestimulus Activity at JoVE.com

Psychophysically-anchored, Robust Thresholding in Studying Pain-related Lateralization of Oscillatory Prestimulus Activity

Psychophysical methods such as the QUEST estimation procedure can efficiently yield robust estimates of the stimulation intensity at which nonpainful sensations transition into painful sensations. By stimulating repeatedly at the threshold intensity, the variability in rating responses can directly be attributed to perceptual classifications in subsequent analyses.

In perceptual studies, it is often important to objectively assess the equality of delivered stimulation across participants or to quantify the ...

psychophysically-anchored-robust-thresholding-studying-pain-related

Universidad San Sebastian

Research

JoVE Journal

Behavior

6.9K Views.  University Medical Center Hamburg Eppendorf. Psychophysical methods such as the QUEST estimation procedure can efficiently yield robust estimates of the stimulation intensity at which nonpainful sensations transition into painful sensations. By stimulating repeatedly at the threshold intensity, the variability in rating responses can directly be attributed to perceptual classifications in subsequent analyses.

Video: Psychophysically-anchored, Robust Thresholding in Studying Pain-related Lateralization of Oscillatory Prestimulus Activity

Infant Auditory Processing and Event-related Brain Oscillations

Rapid auditory processing and acoustic change detection abilities play a critical role in allowing human infants to efficiently process the fine spectral and temporal changes that are characteristic of human language. These abilities lay the foundation for effective language acquisition; allowing infants to hone in on the sounds of their native language. Invasive procedures in animals and scalp-recorded potentials from human adults suggest that simultaneous, rhythmic activity (oscillations) between and within brain regions are fundamental to sensory development; determining the resolution with which incoming stimuli are parsed. At this time, little is known about oscillatory dynamics in human infant development. However, animal neurophysiology and adult EEG data provide the basis for a strong hypothesis that rapid auditory processing in infants is mediated by oscillatory synchrony in discrete frequency bands. In order to investigate this, 128-channel, high-density EEG responses of 4-month old infants to frequency change in tone pairs, presented in two rate conditions (Rapid: 70 msec ISI and Control: 300 msec ISI) were examined. To determine the frequency band and magnitude of activity, auditory evoked response averages were first co-registered with age-appropriate brain templates. Next, the principal components of the response were identified and localized using a two-dipole model of brain activity. Single-trial analysis of oscillatory power showed a robust index of frequency change processing in bursts of Theta band (3 - 8 Hz) activity in both right and left auditory cortices, with left activation more prominent in the Rapid condition. These methods have produced data that are not only some of the first reported evoked oscillations analyses in infants, but are also, importantly, the product of a well-established method of recording and analyzing clean, meticulously collected, infant EEG and ERPs. In this article, we describe our method for infant EEG net application, recording, dynamic brain response analysis, and representative results.

High-density electroencephalography (dEEG) is being used increasingly to study brain development and plasticity in the early years of life. Here we present an application of sophisticated analysis techniques that builds on traditional EEG recording to understand the oscillatory dynamics of rapid auditory processing in the infant brain.

Rapid auditory processing and acoustic change detection abilities play a critical role in allowing human infants to efficiently process the fine spectral ...

Combined Invasive Subcortical and Non-invasive Surface Neurophysiological Recordings for the Assessment of Cognitive and Emotional Functions in Humans

In spite of the success in applying non-invasive electroencephalography (EEG), magneto-encephalography (MEG) and functional magnetic resonance imaging (fMRI) for extracting crucial information about the mechanism of the human brain, such methods remain insufficient to provide information about physiological processes reflecting cognitive and emotional functions at the subcortical level. In this respect, modern invasive clinical approaches in humans, such as deep brain stimulation (DBS), offer a tremendous possibility to record subcortical brain activity, namely local field potentials (LFPs) representing coherent activity of neural assemblies from localized basal ganglia or thalamic regions. Notwithstanding the fact that invasive approaches in humans are applied only after medical indication and thus recorded data correspond to altered brain circuits, valuable insight can be gained regarding the presence of intact brain functions in relation to brain oscillatory activity and the pathophysiology of disorders in response to experimental cognitive paradigms. In this direction, a growing number of DBS studies in patients with Parkinson&#39;s disease (PD) target not only motor functions but also higher level processes such as emotions, decision-making, attention, memory and sensory perception. Recent clinical trials also emphasize the role of DBS as an alternative treatment in neuropsychiatric disorders ranging from obsessive compulsive disorder (OCD) to chronic disorders of consciousness (DOC). Consequently, we focus on the use of combined invasive (LFP) and non-invasive (EEG) human brain recordings in assessing the role of cortical-subcortical structures in cognitive and emotional processing trough experimental paradigms (e.g. speech stimuli with emotional connotation or paradigms of cognitive control such as the Flanker task), for patients undergoing DBS treatment.

The present protocol aims at assessing cognitive-emotional functions in the basal ganglia by simultaneous neurophysiological recording of local field potentials and non-invasive brain cortical activity (EEG). The procedure is exemplified by the use of paradigms involving speech stimuli with emotional connotation or the Flanker task involving cognitive control.

In spite of the success in applying non-invasive electroencephalography (EEG), magneto-encephalography (MEG) and functional magnetic resonance imaging ...

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery

Human pain models are useful in the assessing the analgesic effect of drugs, providing information about a drug&#39;s pharmacology and identify potentially suitable therapeutic populations. The need to use a comprehensive battery of pain models is highlighted by studies whereby only a single pain model, thought to relate to the clinical situation, demonstrates lack of efficacy. No single experimental model can mimic the complex nature of clinical pain. The integrated, multi-modal pain task&#160;battery presented here encompasses the electrical stimulation task, pressure stimulation task, cold pressor task, the UVB inflammatory model which includes a thermal task and a paradigm for inhibitory conditioned pain modulation. These human pain models have been tested for predicative validity and reliability both in their own right and in combination, and can be used repeatedly, quickly, in short succession, with minimum burden for the subject and with a modest quantity of equipment. This allows a drug to be fully characterized and profiled for analgesic effect which is especially useful for drugs with a novel or untested mechanism of action.

Human pain models are valuable tools used to assess the analgesic potential of novel compounds and predict their clinical efficacy, especially when used in an integrated manner. Although implementation of these models is complex, with proper execution, the pain models described in this protocol can provide predictive and reliable results.

Human pain models are useful in the assessing the analgesic effect of drugs, providing information about a drug&#39;s pharmacology and identify ...

Monitoring Acupuncture Effects on Human Brain by fMRI

Functional MRI is used to study the effects of acupuncture on the BOLD response and the functional connectivity of the human brain.  Results demonstrate that acupuncture mobilizes a limbic-paralimbic-neocortical network and its anti-correlated sensorimotor/paralimbic network at multiple levels of the brain and that the hemodynamic response is influenced by the psychophysical response.  Physiological monitoring may be performed to explore the peripheral response of the autonomic nerve function. This video describes the studies performed at LI4 (hegu), ST36 (zusanli) and LV3 (taichong), classical acupoints that are commonly used for modulatory and pain-reducing actions. Some issues that require attention in the applications of fMRI to acupuncture investigation are noted.

FMRI and physiological monitoring is used to study the effects of Acupuncture on the central and peripheral nervous systems. Acupuncture mobilizes a limbic-paralimbic-neocortical network, with great overlap with the default mode network, to modulate neurological activity, possibly related to its autonomic effect in the peripheral nervous system.

Functional MRI is used to study the effects of acupuncture on the BOLD response and the functional connectivity of the human brain.  Results demonstrate ...

Biology

Simultaneous Recordings of Cortical Local Field Potentials and Electrocorticograms in Response to Nociceptive Laser Stimuli from Freely Moving Rats

Electrocortical responses, elicited by laser heat pulses that selectively activate nociceptive free nerve endings, are widely used in many animal and human studies to investigate the cortical processing of nociceptive information. These laser-evoked brain potentials (LEPs) consist of several transient responses that are time-locked to the onset of laser stimuli. However, the functional properties of the LEP responses are still largely unknown, due to the lack of a sampling technique that can simultaneously record neural activities at the surface of the cortex (i.e., electrocorticogram [ECoG] and scalp electroencephalogram [scalp EEG]) and inside the brain (i.e., local field potential [LFP]). To address this issue, we present here an animal protocol using freely moving rats. This protocol is composed of three main procedures: (1) animal preparation and surgical procedures, (2) a simultaneous recording of ECoG and LFP in response to nociceptive laser stimuli, and (3) data analysis and feature extraction. Specifically, with the help of a 3D-printed protective shell, both ECoG and LFP electrodes implanted on the rat&#39;s skull were securely held together. During data collection, laser pulses were delivered on the rat&#39;s forepaws through gaps in the bottom of the chamber when the animal was in spontaneous stillness. Ongoing white noise was played to avoid the activation of the auditory system by the laser-generated ultrasounds. As a consequence, only nociceptive responses were selectively recorded. Using the standard analytical procedures (e.g., band-pass filtering, epoch extraction, and baseline correction) to extract stimulus-related brain responses, we obtained results showing that LEPs with a high signal-to-noise ratio were simultaneously recorded from ECoG and LFP electrodes. This methodology makes the simultaneous recording of ECoG and LFP activities possible, which provides a bridge of electrocortical signals at the mesoscopic and macroscopic levels, thereby facilitating the investigation of nociceptive information processing in the brain.

We developed a technique that simultaneously records both electrocorticography and local field potentials in response to nociceptive laser stimuli from freely moving rats. This technique helps establish a direct relationship of electrocortical signals at the mesoscopic and macroscopic levels, which facilitates the investigation of nociceptive information processing in the brain.

Electrocortical responses, elicited by laser heat pulses that selectively activate nociceptive free nerve endings, are widely used in many animal and ...

Multi-Modal Signals for Analyzing Pain Responses to Thermal and Electrical Stimuli

The assessment of pain relies mostly on methods that require a person to communicate. However, for people with cognitive and verbal impairments, existing methods are not sufficient as they lack reliability and validity. To approach this problem, recent research focuses on an objective pain assessment facilitated by parameters of responses derived from physiology, and video and audio signals. To develop reliable automated pain recognition systems, efforts have been made in creating multimodal databases in order to analyze pain and detect valid pain patterns. While the results are promising, they only focus on discriminating pain or pain intensities versus no pain. In order to advance this, research should also consider the quality and duration of pain as they provide additional valuable information for more advanced pain management. To complement existing databases and the analysis of pain regarding quality and length, this paper proposes a psychophysiological experiment to elicit, measure, and collect valid pain reactions. Participants are subjected to painful stimuli that differ in intensity (low, medium, and high), duration (5 s / 1 min), and modality (heat / electric pain) while audio, video (e.g., facial expressions, body gestures, facial skin temperature), and physiological signals (e.g., electrocardiogram [ECG], skin conductance level [SCL], facial electromyography [EMG], and EMG of M. trapezius) are being recorded. The study consists of a calibration phase to determine a subject&#8217;s individual pain range (from low to intolerable pain) and a stimulation phase in which pain stimuli, depending on the calibrated range, are applied. The obtained data may allow refining, improving, and evaluating automated recognition systems in terms of an objective pain assessment. For further development of such systems and to investigate pain reactions in more detail, additional pain modalities such as pressure, chemical, or cold pain should be included in future studies. Recorded data of this study will be released as the &#8220;X-ITE Pain Database&#8221;.

This article focuses on the experimental elicitation of pain through heat (thermal) and electrical stimulation while recording physiological, visual, and paralinguistic responses. It aims at collecting valid multimodal data for analyzing pain based on its intensity, quality, and duration.&#160;

The assessment of pain relies mostly on methods that require a person to communicate. However, for people with cognitive and verbal impairments, existing ...

Dynamic Quantitative Sensory Testing to Characterize Central Pain Processing

Central facilitation and modulation of incoming nociceptive signals play an important role in the perception of pain. Disruption in central pain processing is present in many chronic pain conditions and can influence responses to specific therapies. Thus, the ability to precisely describe the state of central pain processing has profound clinical significance in both prognosis and prediction. Because it is not practical to record neuronal firings directly in the human spinal cord, surrogate behavior tests become an important tool to assess the state of central pain processing. Dynamic QST is one such test, and can probe both the ascending facilitation and descending modulation of incoming nociceptive signals via TS and CPM, respectively. Due to the large between-individual variability in the sensitivity to noxious signals, standardized TS and CPM tests may not yield any meaningful data in up to 50% of the population due to floor or ceiling effects. We present methodologies to individualize TS and CPM so we can capture these measures in a broader range of individuals than previously possible. We have used these methods successfully in several studies at the lab, and data from one ongoing study will be presented to demonstrate feasibility and potential applications of the methods.

By assessing pain in response to repetitive or different types of standardized stimuli, dynamic quantitative sensory testing (QST) can reveal changes in the central processing of pain. We present methods to optimize and individualize two dynamic QST measures: temporal summation (TS) and conditioned pain modulation (CPM).

Central facilitation and modulation of incoming nociceptive signals play an important role in the perception of pain. Disruption in central pain ...

Neuroscience

Electrophysiological Measurement of Noxious-evoked Brain Activity in Neonates Using a Flat-tip Probe Coupled to Electroencephalography

Pain is an unpleasant sensory and emotional experience. In non-verbal patients, it is very difficult to measure pain, even with pain assessment tools. Those tools are subjective or determine secondary physiological indicators which also have certain limitations particularly when exploring the effectiveness of analgesia. As cortical processing is essential for pain perception, brain activity measures may provide a useful approach to assess pain in infants. Here we present a method to assess nociception with electrophysiological brain activity recordings optimized for the use in newborn infants. To produce highly standardized and reproducible noxious stimuli we applied mechanical stimulation with a flat-tip probe, e.g., PinPrick, which is not skin-breaking and does not cause behavioral distress. The noxious-evoked potential allows the objective measurement of nociception in non-verbal patients. This method can be used in newborn infants as early as 34 weeks of gestational age. Moreover, it could be applied in different situations such as measuring the efficacy of analgesic or anesthetic drugs.

Measuring pain in non-verbal patients is a challenge. In this study we combine EEG recording with stimulation using a flat-tip probe to detect noxious-evoked brain activity in an objective manner.

Pain is an unpleasant sensory and emotional experience. In non-verbal patients, it is very difficult to measure pain, even with pain assessment tools. ...

Medicine

Detecting Pre-Stimulus Source-Level Effects on Object Perception with Magnetoencephalography

Pre-stimulus oscillatory brain activity influences upcoming perception. The characteristics of this pre-stimulus activity can predict whether a near-threshold stimulus will be perceived or not perceived, but can they also predict which one of two competing stimuli with different perceptual contents is perceived? Ambiguous visual stimuli, which can be seen in one of two possible ways at a time, are ideally suited to investigate this question. Magnetoencephalography (MEG) is a neurophysiological measurement technique that records magnetic signals emitted as a result of brain activity. The millisecond temporal resolution of MEG allows for a characterization of oscillatory brain states from as little as 1 second of recorded data. Presenting an empty screen around 1 second prior to the ambiguous stimulus onset therefore provides a time window in which one can investigate whether pre-stimulus oscillatory activity biases the content of upcoming perception, as indicated by participants&#39;&#160;reports. The spatial resolution of MEG is not excellent, but sufficient to localise sources of brain activity at the centimetre scale. Source reconstruction of MEG activity then allows for testing hypotheses about the oscillatory activity of specific regions of interest, as well as the time- and frequency-resolved connectivity between regions of interest. The described protocol enables a better understanding of the influence of spontaneous, ongoing brain activity on visual perception.

This article describes how to set up an experiment that allows detecting pre-stimulus source-level influences on object perception using magnetoencephalography (MEG). It covers stimulus material, experimental design, MEG recording, and data analysis.

Pre-stimulus oscillatory brain activity influences upcoming perception. The characteristics of this pre-stimulus activity can predict whether a ...

Modulation of the Neurophysiological Response to Fearful and Stressful Stimuli Through Repetitive Religious Chanting

In neuropsychological experiments, the late positive potential (LPP) is an event-related potential (ERP) component that reflects the level of one's emotional arousal. This study investigates whether repetitive religious chanting modulates the emotional response to fear- and stress-provoking stimuli, thus leading to a less responsive LPP. Twenty-one participants with at least one year of experience in the repetitive religious chanting of "Amitabha Buddha" were recruited. A 128-channel electroencephalography (EEG) system was used to collect EEG data. The participants were instructed to view negative or neutral pictures selected from the International Affective Picture System (IAPS) under three conditions: repetitive religious chanting, repetitive nonreligious chanting, and no chanting. The results demonstrated that viewing the negative fear- and stress-provoking pictures induced larger LPPs in the participants than viewing neutral pictures under the no-chanting and nonreligious chanting conditions. However, this increased LPP largely disappeared under repetitive religious chanting conditions. The findings indicate that repetitive religious chanting may effectively alleviate the neurophysiological response to fearful or stressful situations for practitioners.

The present event-related potential (ERP) study provides a unique protocol for investigating how religious chanting can modulate negative emotions. The results demonstrate that the late positive potential (LPP) is a robust neurophysiological response to negative emotional stimuli and can be effectively modulated by repetitive religious chanting.

In neuropsychological experiments, the late positive potential (LPP) is an event-related potential (ERP) component that reflects the level of one's ...